Picky Eaters

Kelly Dorfman, MS, LND, offers solutions to common obstacles such as sensory issues and nutritional deficiencies seen in children who are picky eaters.

Children with developmental delays and chronic health conditions are often picky eaters. Generally, neither clever recipes nor attempts to hide healthy foods in “accepted” ones will correct poor intake. It is better to determine the cause and correct the problem from the inside out.

Picky Eaters Problem 1: Sensory Misreading in the Mouth or Poor Oral-Motor Skills

A child with tactile defensiveness often exhibits hypersensitivity in the mouth and/or craves oral stimulation, such as chewing on his clothes. Low muscle tone in the mouth and face often coexists with deeper oral-motor issues. Poor sucking, chewing and swallowing skills can cause gagging or terror merely being near food.

Passing a medical swallow study does not guarantee that a child can chew and swallow consistently and has the stamina to consume an entire meal.

Possible Solutions for Problems in the Mouth

A speech or occupational therapist with oral-motor training can help. Teaching the child to use an electric toothbrush to massage (desensitize) the mouth or to drink from a straw can strengthen oral-motor skills and greatly reduce eating anxiety. Helpful books are Progress with Puppets.

Picky Eaters Problem 2: Nutritional Deficiency

Poor eating creates nutritional imbalances, which further reduce appetite or increase carbohydrate cravings. Deficiencies in zinc and vitamin B1 contribute to anorexia, but a specific nutrient deficiency need not be present.

General malnutrition can contribute to disinterest in food, leading to further malnutrition, reducing appetite increasingly over time.

Possible Solutions for Nutritional Deficiencies

Children cannot be forced to eat the necessary diet to correct malnutrition. Once they become malnourished, diet alone may not correct the deficiencies, particularly if children have poor absorption or delivery of nutrients.

Best to use nutrient supplements with moderate levels of a broad range of vitamins (C, E, and B-6) and minerals (magnesium, molybdenum, chromium and selenium) that are most deficient in a overly processed diet.

Liquid nutrients are available for children who refuse chewables. Pills ground up in a mortar and pestle can be mixed with frozen grape juice concentrate, applesauce, strained pears, or, in desperate cases, chocolate syrup.

Picky Eaters Problem 3: Weak Digestive Function

Children with a a digestive system that is immature, inflamed or inefficient may have a history of any of the following:

Most cases are subtle, with a heavy or sinking feeling accompanying eating. These children are uncomfortable and tend to avoid eating, becoming high risk for malnutrition. They do not know how a happy tummy feels, from lack of comparison.

Possible Solutions for Weak Digestive Function

The Comprehensive Digestive Stool Analysis by Genova Diagnostics is one of several tests that evaluate subtle digestive issues. A physician must order these tests.

Another solution may be digestive tonics. A traditional remedy for weak digestion and internal inflammation is ginger “tea” made by boiling peeled root slices, then cooled and served a few teaspoons at a time (possibly with honey for children older than one), several times per day.

Digestive enzymes in small amounts may increase appetite, but, if used in excess, can loosen stools or cause intestinal cramping. Digestive capacity diminishes as the day progresses, so, if trying enzymes, always start at dinner, the most problematic meal for poor digesters.

Picky Eaters Problem 4: Drug Side Effects

Stimulants such as Ritalin and Dexedrine decrease appetite. Antibiotics can also reduce appetite by increasing yeast overgrowth and damaging the intestine’s lining. Yeast overgrowth can turn the intestines into a fermentation machine. When yeast digest sugars, the intestines bloat, sending either a “full” signal or a call for more carbohydrates.

Possible Solutions for Drug Side Effects

If stimulants severely affect the appetite, re-evaluate the side-effect/benefit ratio. Stimulants are controlled substances, and their use in a young child should yield huge benefits to justify the long-term costs (both known and unknown).

If stimulants are deemed absolutely necessary, feed the child dinner foods for breakfast, because he will eat little while the drug is in the system. After school, when the medicine is breaking down, feed a second dinner, rather than snacks. Then at 7:00 pm, bring out the low-sugar cereal, toast and snacks.

Although picky eaters can be interpreted as having a behavioral issue and treated with behavioral modification, it frequently has nutritional causes. By playing detective, parents can determine ­which solution is right for an individual child.

About Kelly Dorfman MS LND

Kelly Dorfman is one of the world’s foremost experts on using nutrition therapeutically to improve brain function, energy and mood. Kelly’s special talent for integrating information from many sources and finding practical solutions has made her a popular speaker and workshop leader. She lectures extensively and is a member of Platform (formerly the National Speakers Association) and has been featured on numerous television programs including CNN’s American Morning.

Kelly’s award winning book, Cure Your Child With Food: The Hidden Connection Between Nutrition and Childhood Ailments (formerly known as What’s Eating Your Child) was given rave reviews by Publishers Weekly and the Washington Post.

As a go-to expert on nutrition issues, Kelly is frequently interviewed and quoted in the media. She has been featured in articles in The Wall Street Journal, Parade, Bethesda magazine, Living Without magazine, and the Huffington Post.

Kelly holds a master’s degree in nutrition/biology and is a licensed nutrition dietitian. She is a co-founder of Developmental Delay Resources, which has merged with Epidemic Answers. You can find out more about Kelly and her practice at kellydorfman.com